Healthcare Provider Details

I. General information

NPI: 1528661378
Provider Name (Legal Business Name): NABILA FAGHFOOR RPH, PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2020
Last Update Date: 11/16/2020
Certification Date: 11/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28201 DIEHL RD
WARRENVILLE IL
60555-3934
US

IV. Provider business mailing address

28201 DIEHL RD
WARRENVILLE IL
60555-3934
US

V. Phone/Fax

Practice location:
  • Phone: 630-657-5565
  • Fax: 331-333-4397
Mailing address:
  • Phone: 630-657-5565
  • Fax: 331-333-4397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051299135
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number64878
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: